A 42-year-old woman with keratoconus developed painful loss of vision secondary to acute hydrops. A large Descemet’s membrane (DM) rupture was observable inferotemporally, with the central DM appearing normal. After 6 weeks of no spontaneous improvement, hemi-nDSEK was performed, placing a semi-circular donor lenticule of 9mm diameter over the area of ruptured DM. Prompt resolution of corneal oedema was observed. Due to the lack of involvement of the central cornea, no further intervention was required and the patient regained visual acuity of logMAR 0.40 with a rigid contact lens.

Conclusions:

nDSEK has been used previously in cases of acute corneal hydrops. This is the first reported case of hemi-nDSEK being used in this scenario, with the advantage that the central, healthy host endothelium and DM is preserved and rapid visual rehabilitation can be achieved.